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Measurement of bone turnover in prostate cancer patients receiving intermittent androgen suppression therapy.

Theyer G, Holub S, Olszewski U, Hamilton G - Open Access J Urol (2010)

Bottom Line: Serum CrossLaps concentrations peaked at the last 2 months of the AS phases (0.91 ± 0.25 μg/L; mean ± SEM) and were reduced below initial values (0.21 ± 0.43 versus baseline of 0.43 ± 0.06 μg/L) during therapy cessation periods until tumor progression-related increases.Measurements of the serum concentration of CrossLaps in prostate cancer patients receiving IAS indicated that treatment cessation phases rapidly reversed increased bone degradation associated with AS phases, in strong agreement with the clinical observations reporting reduced loss of BMD in IAS when compared to CAS.In terms of clinical outcomes, IAS seems to be as effective as CAS while showing reduced side effects, as demonstrated here by the reduction of androgen-induced bone matrix degradation.

View Article: PubMed Central - PubMed

Affiliation: Hospital Kittsee, Kittsee, Burgenland, Austria;

ABSTRACT

Purpose: Reports on clinical measurements of bone mineral density (BMD) in prostate cancer patients undergoing intermittent androgen suppression therapy (IAS) that allows for hormonal recovery between treatment cycles indicate decreased osteoporosis compared to continuous androgen suppression therapy (CAS). In the present study the effect of IAS on bone metabolism by determinations of CrossLaps, a biochemical marker of collagen degradation, were examined.

Method: In total 100 IAS treatment cycles of 75 patients with prostate cancer stages ≥ pT2 were studied. Clinical data and monthly laboratory tests (testosterone, prostate-specific antigen; PSA) of these patients were monitored together with measurements of C-terminal telopeptide collagen fragments using CrossLaps® ELISA assays.

Results: During phases of androgen suppression (AS) lasting for 9 months serum testosterone (<1 ng/mL) and PSA (<2 ng/mL) levels were reversibly reduced, indicating partial growth arrest and apoptotic regression of the prostatic tumors. Serum CrossLaps concentrations peaked at the last 2 months of the AS phases (0.91 ± 0.25 μg/L; mean ± SEM) and were reduced below initial values (0.21 ± 0.43 versus baseline of 0.43 ± 0.06 μg/L) during therapy cessation periods until tumor progression-related increases.

Conclusion: Measurements of the serum concentration of CrossLaps in prostate cancer patients receiving IAS indicated that treatment cessation phases rapidly reversed increased bone degradation associated with AS phases, in strong agreement with the clinical observations reporting reduced loss of BMD in IAS when compared to CAS. In terms of clinical outcomes, IAS seems to be as effective as CAS while showing reduced side effects, as demonstrated here by the reduction of androgen-induced bone matrix degradation.

No MeSH data available.


Related in: MedlinePlus

Individual time courses of testosterone, PSA (A), and CrossLaps serum levels (B) for a representative patient undergoing IAS (mean ± SD calculated for each treatment period). Values cover the pretreatment time point, AS phases (AI– AIV), and treatment cessation periods (PI–PIII).
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f1-oaju-2-155: Individual time courses of testosterone, PSA (A), and CrossLaps serum levels (B) for a representative patient undergoing IAS (mean ± SD calculated for each treatment period). Values cover the pretreatment time point, AS phases (AI– AIV), and treatment cessation periods (PI–PIII).

Mentions: Individual time courses of concentrations of testosterone, PSA, and CrossLaps for a representative patient undergoing IAS are depicted in Figure 1. Mean values of the parameters that were measured in monthly intervals for cessation (PI: 12, PII: 9, and PIII: 8 measurements) and treatment (9 measurements averaged for each phase AI to AIV) periods, respectively, are shown. Testosterone and PSA were significantly elevated during treatment breaks compared to the AS periods and concentrations of CrossLaps increased periodically and reversibly during AS, indicating increased bone catabolism during AS and recovery during cessation phases.


Measurement of bone turnover in prostate cancer patients receiving intermittent androgen suppression therapy.

Theyer G, Holub S, Olszewski U, Hamilton G - Open Access J Urol (2010)

Individual time courses of testosterone, PSA (A), and CrossLaps serum levels (B) for a representative patient undergoing IAS (mean ± SD calculated for each treatment period). Values cover the pretreatment time point, AS phases (AI– AIV), and treatment cessation periods (PI–PIII).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3818886&req=5

f1-oaju-2-155: Individual time courses of testosterone, PSA (A), and CrossLaps serum levels (B) for a representative patient undergoing IAS (mean ± SD calculated for each treatment period). Values cover the pretreatment time point, AS phases (AI– AIV), and treatment cessation periods (PI–PIII).
Mentions: Individual time courses of concentrations of testosterone, PSA, and CrossLaps for a representative patient undergoing IAS are depicted in Figure 1. Mean values of the parameters that were measured in monthly intervals for cessation (PI: 12, PII: 9, and PIII: 8 measurements) and treatment (9 measurements averaged for each phase AI to AIV) periods, respectively, are shown. Testosterone and PSA were significantly elevated during treatment breaks compared to the AS periods and concentrations of CrossLaps increased periodically and reversibly during AS, indicating increased bone catabolism during AS and recovery during cessation phases.

Bottom Line: Serum CrossLaps concentrations peaked at the last 2 months of the AS phases (0.91 ± 0.25 μg/L; mean ± SEM) and were reduced below initial values (0.21 ± 0.43 versus baseline of 0.43 ± 0.06 μg/L) during therapy cessation periods until tumor progression-related increases.Measurements of the serum concentration of CrossLaps in prostate cancer patients receiving IAS indicated that treatment cessation phases rapidly reversed increased bone degradation associated with AS phases, in strong agreement with the clinical observations reporting reduced loss of BMD in IAS when compared to CAS.In terms of clinical outcomes, IAS seems to be as effective as CAS while showing reduced side effects, as demonstrated here by the reduction of androgen-induced bone matrix degradation.

View Article: PubMed Central - PubMed

Affiliation: Hospital Kittsee, Kittsee, Burgenland, Austria;

ABSTRACT

Purpose: Reports on clinical measurements of bone mineral density (BMD) in prostate cancer patients undergoing intermittent androgen suppression therapy (IAS) that allows for hormonal recovery between treatment cycles indicate decreased osteoporosis compared to continuous androgen suppression therapy (CAS). In the present study the effect of IAS on bone metabolism by determinations of CrossLaps, a biochemical marker of collagen degradation, were examined.

Method: In total 100 IAS treatment cycles of 75 patients with prostate cancer stages ≥ pT2 were studied. Clinical data and monthly laboratory tests (testosterone, prostate-specific antigen; PSA) of these patients were monitored together with measurements of C-terminal telopeptide collagen fragments using CrossLaps® ELISA assays.

Results: During phases of androgen suppression (AS) lasting for 9 months serum testosterone (<1 ng/mL) and PSA (<2 ng/mL) levels were reversibly reduced, indicating partial growth arrest and apoptotic regression of the prostatic tumors. Serum CrossLaps concentrations peaked at the last 2 months of the AS phases (0.91 ± 0.25 μg/L; mean ± SEM) and were reduced below initial values (0.21 ± 0.43 versus baseline of 0.43 ± 0.06 μg/L) during therapy cessation periods until tumor progression-related increases.

Conclusion: Measurements of the serum concentration of CrossLaps in prostate cancer patients receiving IAS indicated that treatment cessation phases rapidly reversed increased bone degradation associated with AS phases, in strong agreement with the clinical observations reporting reduced loss of BMD in IAS when compared to CAS. In terms of clinical outcomes, IAS seems to be as effective as CAS while showing reduced side effects, as demonstrated here by the reduction of androgen-induced bone matrix degradation.

No MeSH data available.


Related in: MedlinePlus